Our overall objective is to develop and evaluate methods for the prevention and control of hospital-acquired urinary tract infections associated with the use of indwelling bladder catheters. We have established continuing daily bacteriologic monitoring of urinary drainage systems by catheter care team and have developed methods for incorporating our bacteriologic and epidemiologic data into patients' computerized hospital records. We propose to evaluate our monitoring system as a technic to assist in patient care, medical audit, and long-term epidemiologic study. We are conducting systematic studies of methods which may help prevent catheter-associated infections. These methods include the use of silicone catheters and daily meatal care with various disinfectants. We have identified meatal colonization with gram-negative bacilli as a major risk factor for later bacteriuria, and we are studying epidemiologic determinants of meatal colonization as well as technics to block retrograde extra-lumenal spread of bacteria into the urinary bladder.